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Digestive Symptom

Constipation

Constipation — infrequent, difficult or incomplete bowel movements — is one of the most common digestive complaints in the UK, affecting around 1 in 7 adults. It can be acute or chronic, and for many people is significantly influenced by stress, anxiety, diet and lifestyle. A range of dietary, lifestyle and complementary approaches can provide effective relief.

See therapies that may help

What is Constipation?

Constipation is defined as having fewer than three bowel movements per week, or as passing hard, dry or lumpy stools that are difficult or painful to pass. It may also involve a feeling of incomplete emptying after defecation, or a sense of blockage.

Acute constipation has many common causes including dietary changes (low fibre, insufficient fluid), reduced physical activity, travel, medication side effects and pregnancy. Chronic constipation may involve functional (no identifiable cause) or secondary (an underlying condition) factors.

The gut-brain connection is significant in constipation — stress and anxiety alter gut motility through the enteric nervous system, and constipation is extremely common in people with anxiety disorders or IBS. Addressing psychological factors can be as important as dietary changes for chronic functional constipation.

Signs and symptoms

Signs of constipation include:

  • Fewer than three bowel movements per week
  • Hard, lumpy or dry stools
  • Straining to pass stools
  • Feeling of incomplete emptying
  • Abdominal bloating or discomfort
  • Needing manual assistance to empty the bowel

Seek medical attention if constipation is new and persistent, associated with unexplained weight loss, rectal bleeding, or a change in the shape of stools — particularly if you are over 50.

How therapy can help

Most constipation responds well to lifestyle and dietary measures, with complementary therapies offering additional support:

  • Dietary fibre increase — gradually increasing dietary fibre (particularly soluble fibre) alongside adequate fluid intake is foundational
  • Physical activity — exercise stimulates gut motility and is one of the simplest evidence-based interventions for constipation
  • Abdominal massage — following the direction of the colon (ascending, transverse, descending) has evidence for reducing constipation, particularly in certain populations
  • Acupuncture — some evidence for improving bowel frequency and reducing straining in chronic constipation
  • Reflexology — used by some practitioners for digestive complaints including constipation
  • Mindfulness and stress reduction — for constipation with a significant stress component, reducing autonomic nervous system arousal can improve gut motility
  • Hypnotherapy — gut-directed hypnotherapy has evidence for functional digestive disorders including constipation-predominant IBS

Seeking help

For most cases of constipation, self-management with dietary and lifestyle changes is the first step. If constipation is persistent despite these measures, GP assessment is advisable to rule out underlying causes and discuss pharmacological options. A dietitian can provide tailored dietary advice.

Therapies that may help with Constipation

Showing 2 therapies linked to Constipation.

Therapy Evidence Notes
Colon Hydrotherapy Therapist
limited

Not a first-line medical treatment; persistent symptoms need GP review.

Maya Abdominal Therapist
limited

Supportive alongside hydration/fibre/movement strategies.

Frequently asked questions

How long is too long to be constipated?

Occasional constipation lasting a few days is common and usually resolves with increased fibre and fluids. Constipation that persists for more than two weeks, or that significantly affects quality of life, warrants assessment. New constipation in older adults should always be assessed by a GP.

Does stress cause constipation?

Yes — stress and anxiety alter gut motility through the gut-brain axis. Some people experience diarrhoea under stress; others experience constipation. The pattern tends to be consistent for a given individual. Addressing stress and anxiety is an important component of management for stress-related constipation.

Can abdominal massage help constipation?

Yes — abdominal massage following the path of the colon (clockwise from the lower right abdomen) has evidence for improving bowel frequency and reducing discomfort in chronic constipation. It can be self-administered or performed by a massage therapist.

Is it normal to not have a bowel movement every day?

Normal bowel frequency ranges from three times per day to three times per week. Not having a daily bowel movement is entirely normal for many people. Constipation is defined not just by frequency but by stool consistency and the presence of straining or difficulty.

Can laxatives make constipation worse long-term?

Stimulant laxatives (such as senna) are appropriate for short-term use but should not be relied upon long-term, as they can potentially reduce the bowel's natural motility with prolonged use. Osmotic laxatives (such as polyethylene glycol) have a better safety profile for longer-term use. Dietary and lifestyle approaches are preferable for chronic management.